British Association of Dermatologists Guidelines for the Management of Hidradenitis Suppurativa (Acne Inversa) 2018

J.R. Ingram; F. Collier; D. Brown; T. Burton; J. Burton; M.F. Chin; N. Desai; T.E.E. Goodacre; V. Piguet; A.E. Pink; L.S. Exton; M.F. Mohd Mustapa


The British Journal of Dermatology. 2019;180(5):1009-1017. 

In This Article


What can a person with HS do to help manage their condition? In most areas, evidence is weak or absent; however, a list of suggestions is provided below following feedback from patient/carer representatives on the GDG:

  • Obtain up-to-date information about HS from the BAD's Patient Information Leaflet web page (

  • Consider joining a patient support group, such as the HS Trust in the U.K. ( Mutual support is available via associated social media groups.

  • Obtain adequate pain relief from your General Practitioner (GP) to help manage the pain associated with HS flares or chronically active disease.

  • Avoid tight clothing and synthetic materials, which can increase friction and may contribute to flares.

  • Obtain wound dressings from your GP to help manage actively pus-producing lesions. Incontinence pads might be needed for high volume of discharge.

  • HS is not a disease of poor hygiene; however, using an antiseptic wash, such as chlorhexidine solution for the shower, available via your GP, may be beneficial.

  • There is no high-quality evidence that particular diets are helpful in HS.

  • If you are overweight, weight reduction may improve your disease severity and, depending on BMI, support from NHS weight-management services may be obtained.

  • Smoking is a risk factor for development of HS and people with HS have a relatively high risk of cardiovascular disease, so stopping smoking, if you currently smoke, is an important part of self-management.

  • Depression is more common in those with HS and it is important to seek help from your GP for low mood, if relevant.